Diseth T H, Bjørnland K, Nøvik T S, Emblem R
National Hospital, Oslo: Division of Child and Adolescent Psychiatry, Norway.
Arch Dis Child. 1997 Feb;76(2):100-6. doi: 10.1136/adc.76.2.100.
Congenital intestinal malformations are uncommon and may pose lasting somatic difficulties. Patients with anorectal anomalies have a high frequency of persistent faecal dysfunction and psychosocial problems. This study examined whether adolescents with Hirschsprung's disease have more psychosocial problems than their healthy peers. Nineteen adolescents (mean age 15.7 years) with Hirschsprung's disease were assessed for bowel function, anorectal physiology, mental health, and psychosocial functioning by physical examinations, semistructured interview, and standardised questionnaires. The adolescents were compared with controls. The parents of 13 adolescents with Hirschsprung's disease were interviewed and completed questionnaires. Thirty two per cent of the adolescents with Hirschsprung's disease had significant impairment of continence, but no more psychopathology (16%) nor psychosocial dysfunction as a group than their healthy peers. Faecal incontinence was associated with poorer psychosocial functioning and parental criticism. The fact that a significant number of patients with Hirschsprung's disease have incontinence into adulthood indicates the need for parental counselling, encouraging realistic expectations about continence.
先天性肠道畸形并不常见，可能会带来持久的身体问题。患有肛门直肠畸形的患者持续性排便功能障碍和心理社会问题的发生率很高。本研究调查了患有先天性巨结肠症的青少年是否比健康同龄人有更多的心理社会问题。通过体格检查、半结构化访谈和标准化问卷，对19名患有先天性巨结肠症的青少年（平均年龄15.7岁）进行了肠道功能、肛门直肠生理学、心理健康和心理社会功能评估。将这些青少年与对照组进行比较。对13名患有先天性巨结肠症的青少年的父母进行了访谈并完成了问卷。32%患有先天性巨结肠症的青少年有明显的控便障碍，但作为一个群体，他们的精神病理学问题（16%）或心理社会功能障碍并不比健康同龄人更多。大便失禁与较差的心理社会功能和父母的批评有关。相当数量的先天性巨结肠症患者成年后仍有失禁问题，这一事实表明需要对父母进行咨询，鼓励他们对控便抱有现实的期望。
